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St. Stanislaus Kostka Church
Catholic Parish in Pleasant Valley, NY
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Home
Registration Form Request
Security
Welcome Back!
COVID19
Archive
Liturgy and Sacraments
Mass Times
Ministry Schedule
Baptism
Marriage
Anointing of the Sick
Information for Sponsors & Godparents
Faith Formation
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
7th Grade
8th Grade
Confirmation
G.I.F.T.
Adult Faith Formation
Parish Organizations and Outreach
Youth Ministry
Prayer Shawl Ministry
Garden Club
Pleasant Valley Food Pantry
Dutchess Outreach - Lunchbox
Dutchess Coalition for the Homeless
Taking it to the Streets
Annual Coat Drive
Baby Bottle Collection
Unplanned Pregnancy Assistance
Lutheran Care Center
Senior Assistance
News / Events
Contact Us
Staff
Bulletins
Photo Albums
Videos
Events
News
Welcome Back Survey
Home
Registration Form Request
Security
Welcome Back!
Welcome Back Survey
St. Stanislaus Kostka Welcome Back Survey
The maximum number of form submissions has been reached. This form is currently not available.
1. How are you and your family doing now?
REQUIRED
(Select One)
a. Not so good, to be honest with you. I/we could really use some prayers and some help.
b. I/we are doing okay. We're hanging in there.
c. I/we are doing pretty good
d. I/we are doing great, actually
Please fill out this field.
2. Did you lose loved ones during the pandemic?
REQUIRED
(Select One)
a. Yes
b. No
Please fill out this field.
If yes, would you share their names so we can pray for them with you? Names:
Please enter valid data.
3. Did you use any of our outreach/programs this past year? (Check all that apply.)
a. Livestream Masses
b. Flock notes
c. Facebook posts
d. In person Masses with social distancing
e. Greeters/ushers at Masses
4. Did you have to postpone or change plans for a sacrament or rite at the parish because of the pandemic? (Check all that apply.)
a. Funeral service for a loved one
b. Wedding
c. Baptism
d. Confirmation
e. First Communion
f. Celebration of a special anniversary such as 50th
g. Other
g. Other:
Please enter valid data.
If yes, should we contact you to discuss and offer our assistance?
Yes
No
5. What are your plans for coming back to Mass?
REQUIRED
(Select One)
a. I’m already attending in person
b. I’ll be back as soon as I’m vaccinated
c. I’ll be back as soon as the “stay at home” permission is lifted (which it may be by the time this is received)
d. I’ll be back as soon as it feels safe to me
e. I’m not sure
Please fill out this field.
f. Other:
Please enter valid data.
6. Are you interested in participating in any of these ministries or programs? (Select all that apply)
a. Children’s Liturgy of the Word
b. Fellowship after Masses
c. Parish retreat
d. Family Catechesis
e. Adult Scripture Study
f. Lutheran Care Center outreach
g. Prayer Shawl Ministry
h. Teen Club
i. Other
Please enter valid data.
7. As we plan for a series of “Welcome Back” activities at our Parish, which activities are most appealing to you and your family?
a. Welcome Back Mass at St. Stanislaus Kostka
b. A Memorial Mass of Remembrance
c. Adult social event/reception or parents-night-out
d. Children’s activity/fair/carnival/scavenger hunt
e. Outdoor movie night or other family activities
f. Trivia night
g. Special Rosary gatherings/ Adoration/worship opportunities
h. Other
Please enter valid data.
8. For the “Welcome Back” activities, would you/your family be interested in attending and/or willing to volunteer to help prepare for this event?
REQUIRED
(Select One)
a. Yes, volunteer to help & then attend the event
b. Yes, attend the event
c. Not interested
d. I am not sure but would like to learn more. Please contact me.
Please fill out this field.
Contact information:
For our records, can you please provide:
Your Name
REQUIRED
Please fill out this field.
Please enter valid data.
Spouse's Name
Please enter valid data.
Child(ren)'s Name(s) & Age(s)
Please enter valid data.
Current Mailing Address
REQUIRED
Please fill out this field.
Please enter valid data.
Your Email
REQUIRED
Please fill out this field.
Please enter valid data.
Spouse's Email
Please enter valid data.
Best phone number to reach you
REQUIRED
Please fill out this field.
Please enter valid data.
How long have you been in the Parish?
REQUIRED
Please fill out this field.
Please enter valid data.
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